Regarding "Costs Rarely Discussed" (Aug. 25): Health care is the only service the consumer must buy before learning how much it costs. Even if a patient has the time or opportunity to find out what a provider charges for a needed procedure, that rarely correlates to the payment amount required by the insurance carrier. First there is the negotiated rate for the service, then there is the deductible and co-pay. Is the provider participating or not? Is the service even covered? There are so many variables, it is impossible to determine the actual out-of-pocket cost until the explanation of benefits arrives.